Orthopaedic appliances



y 2, 1959 R. H. MAUDSLEY ET AL ORTHOPAEDIC APPLIANCES 4 Sheets-Sheet 1Filed May 22, 1956 In very fans,

y 1959 R. H; MAUDSDLEY ET AL 2,886,030 ORTHOPAEDIC APPLIANCES Filed May22, 1956 4 Sheets-Sheet/ 2 May 1959 Filed May 22, 1956 R. H. MAUDSLEY ETAL ORTHOPAEDIC APPLIANCES 4 Sheets-Sheet 5 y 1959 R. H. MAUDSLEY' ET AL2,886,030

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United States Patent M ORTHOPAEDIC APPLIANCES Roy Homer Maudsley, Ascot,and Ernest Matthews, Yeovil, England Application May 22, 1956, SerialNo. 586,600

'Claims priority, application Great Britain May 26, 1955.

15 Claims. (Cl. 128-75) This invention relates to orthopaedic appliancesas employed in hospitals and elsewhere for applying traction orsuspension to a patient or to any part of the body in the practice oforthopaedic treatment or surgery. Appliances hitherto employed for thispurpose have involved the use of cords, pulleys and weights inconjunction with a beam or beams attached to the bed and connected inthe required manner to the limbs or body of the patient. Diflicultiesare frequently encountered in the use of such appliances since someknowledge of mechanics is required for satisfactory results and the bedstructure frequently interferes with the action of the weights. Alsotrouble is often caused by twisting of the cords and by weights becomingdetached. It is one of the objects of the present invention to provideimproved appliances for the purposes in question which are not A2,886,030 Patented May 12, 19 59 2 kind described in any of the Britishpatent specifications Nos. 384,534; 465,925; 648,989; and 648,990. Apreferred form of spring balance comprises a tension spring and atorsion spring both of helical form arranged one 5 within the other andattached at one end to a common subject to the above mentioneddisadvantages and which are simpler to use and neater in appearance. Afurther object is to provide an improved appliance for this purposewhich is less bulky and has fewer separate parts, thereby aifordinggreater convenience and expedition in use.

According to the invention an orthopaedic appliance for applyingtraction or suspension comprises a supporting element or beam adapted tobe secured to or mounted upon a bed or like structure, and a springbalance of the spiral rod type anchored at one end to the element orbeam and having at its extensible end means for the attachment of aflexible means or cable for connection to the body of a patient or apart thereof.

The invention also comprises an appliance according to the precedingparagraph having pulley means adjustably mounted on the supportingelement or beam over which the cable or the like can be trained.

In a preferred arrangement according to the invention a beam element ofhollow or tubular form is provided within which the spring balance isenclosed and 1 having a longitudinal slot in conjunction with anadjustably mounted pulley for the cable or the like attached to theextensible end of the spring balance.

According to a further feature of the invention the extensible end ofthe spring balance is provided with guide means coacting with the beamor support to prevent twisting of the attachment at such extensible endunder the torsion of the balance.

The supporting or beam element is preferably provided with one or moreclamps or other attachments taneously from the same element. 4

The spiral spring balances employed may be of the anchorage. Theopposite end of the tension spring is attached to a carrier or guidestructure which constitutes the extensible end of the balance and towhich is also attached one end of a spirally formed rod which extendsinside the tension spring. The other end of the torsion spring isattached to a nut or slotted member slidable on the spiral rod but notrotatable relative to the latter. The pitch of the spiral rod increasesprogressively from its point of attachment to the carrier. Thearrangement is such that when the balance is first extended its pull isprovided both by extension of the tension spring and by torsion of thetorsion spring acting through the nut on the spiral rod. As theextension continues the load afforded by the torsion spring alonediminishes due to the increased pitch of the spiral rod and hence thetotal pull afforded by the balance remains approximately constant. Itwill be understood that this result may be achieved in other ways asindicated by the patent specifications referred to above.

The clamping devices for securing the beams conveniently comprise openended box structures slidable upon the hollow beams and having clampingscrews for securing them in desired position thereon. For securinghorizontal and vertical beams together a double box clamp structure isprovided, and the box structures may be arranged so that the beams aresecured in one plane or in staggered planes. For securing the beams tobed or cot rails, similar box form clamps may be provided with hookshaped extensions for engaging over the rails.

In the accompanying drawings,

Figure 1 is a sectional elevation of part of a beam unit including aspring balance arranged and constructed in accordance with theinvention;

Figure 2 is a cross section on the line X-X of Figure 1;

Figure 3 is a sectional plan view of the left hand end of Figure 1;

Figure 4 is a diagram illustrating the operation of the spring balance;

Figure 5 is an elevation of a horizontal beam arrangement mounted on abed;

Figure 6 is an elevation of a vertical beam arrangement mounted on abed;

Figure 7 is an elevation of an upper rail clamping bracket;

Figure 8 is an elevation of a lower rail clamping bracket;

Figure 9 is a plan view, partly in section, of Figure 7;

Figure 10 is a plan view, partly in section, of Figure 8;

Figure 11 is an elevation of a clamp for connecting two beams;

Figure 12 shows the invention applied to provide skin traction of a limbwithout overhead support;

Figure 13 shows the invention applied to provide skin traction with abalanced Thomas splint.

In carrying the invention into effect according to one convenient modeas applied to a traction or suspension unit which can be attached to ormounted upon a bed or cot, reference being had to Figures 1, 2 and 3,there is provided a rectilinear hollow beam 1 of metal having arectangular or square section and formed with a slot 2 extendinglongitudinally along one side thereof. A spring balance of the spiralrod type has one end thereof connected to a cap 3. The extensible end ofthe spring balance is attached by a cross pin 4 to a pair of side plates5 which are also attached to a guide block 6 of channel section as seenin Figure 2, the

plates lying in the lateral recesses constituted by the opposedchannels. A second cross pin 7' assists in securing the plates and thefurther ends of these latter are joined by a pin 8 over which is engageda link 9 to which a cable or cord can be attached. The guide block 6 cantravel along the beam interior and is prevented from twisting orrotating therein by its engagement with interior shoulders 10 and thelower edges 11 of the beam. The spring balance comprises an outertension spring 12, a torsion spring 13, and a spiral rod 14. The outerends of the tension spring and spiral rod are attached to the guideblock 6 by means of the pin 4 as seen in Figure 1. Provision ispreferably made for enabling the amount of torsion of the spring 13 tobe adjusted without dismantling the balance. This is efliected byproviding the cap 3 with a sleeve 15 secured therein which receives ahead cylindrical member formed with cylindrical surfaces 17, 18 ofdifierent diameters to which the ends of the springs 12 and 13 areattached. The outer end of the sleeve 15 has one or more ratchet toothformations 19 therein which can be engaged by complementary toothformations 21 formed inwardly of the head 16 which lies outside theouter end of the sleeve. Thus by rotating the head 16, e.g. by asuitable key, the spring torsion can be adjusted. The torsion spring 13lies within the tension spring 12. The spring assembly is enclosed in acylindrical casing 21 which is secured to the guide structure 5, 6 bythe pins or rivets 4 and 7. The spiral rod 14 extends freely within thetorsion spring 13, and the extensible end of the latter carries a nut orslotted member 22 engaging the rod. The pitch of the rod 14 is small atthe carrier end and increases towards the free end of the rod. When thebalance is extended the cylindrical casing 21 is drawn away from theanchored ends of the springs and the nut 22 slides up the spiral rod 14.This relation of the various parts of the balance is illustrateddiagrammatically in Figure 4. The end cap 3 may be conveniently securedto the beam 1 by a ball catch 23 loaded by a spring 24.

Referring to Figure 5, a bracket 25 is slidably mounted on the outsideof the hollow beam 11 and carries a flanged pulley 26 which extendspartly into the beam slot 2 to receive a cable 27 attached to the link 9of the guide structure of the spring balance. The bracket 25 is of openended box construction and carries a screw having a handle 28 forclamping the pulley bracket at any desired position along the beam. inthe arrangement shown in Figure 5, a spring balance S (shown in brokenlines) is anchored at each end of a single beam and two pulley brackets25 are provided for the two cables.

The beams are adapted to be mounted by means of suitable clamps orbrackets on a hospital bed or like structure in any desired position,e.g. either vertical, horizontal, or inclined.

One convenient mode of mounting a vertical beam 1 on two horizontal endrails of a bed is shown in Figure 6. The horizontal bed frame 29 isconnected to the usual vertical frames 30. A pair of box brackets 31 and32 are adjustably clamped upon the beam by headed screws 33. Eachbracket has a hook shaped extending portion 34, see Figures 7, 8, 9 and10, one of which is arranged to engage over the top bed rail 35 and theother is arranged to engage over the lower rail 36. The brackets areadjusted together to engage the rails, and final tightening is eifectedby a clamping screw 37 extending through one of the hook shapedportions. Such an arrangement may be employed for example where it isdesired to apply traction to a single limb. Each book shaped portion 34is provided with a resilient liner comprising a sheet 38 of rubber orthe like secured to a U-shaped metal liner 3% mounted for radial slidingmovement upon a pair of pins 40 located in holes in the bracket.

Where a single horizontal beam above the bed is required, as shown inFigure 5, the beam is supported by a pair of vertical beams attached asdescribed with reference to Figure 6. The connections between thevertical and horizontal beams is efiected by double box clamps. As shownin Figure 11, each clamp comprises an open ended box portion 41 slidablealong the beam and clamped by a screw 42. Attached to the box portion 41in any convenient manner is a rectangular socket or box portion 43 whichfits over the end of the vertical beam and is secured by a clampingscrew 44.

It will be seen that beams as described above can be arranged in variousways and in various combinations, several beams being used together whenit is required to apply several forces acting in diflerent directions.It Will be understood that the required traction or suspension force isto be applied through spring balance means in various ways. Thus twobeams each having a spring balance at each end as shown in Figure 5 canbe arranged side by side in a horizontal plane over the bed to enable apatient in a plaster bed or cradle to be completely sus pended andbalanced by applying the balancing forces at each of four points, and insuch a way that the patient can be moved to a variety of positions andangles. In another arrangement a single balance horizontal beam abovethe bed may be employed to suspend a fractured pelvis. In anotherarrangement a double balance horizontal beam above the bed may beemployed to apply Bryants traction to infants. As shown in Figure 12, asingle vertically arranged balance beam is employed at apply skintraction to a limb by means of a pulley 26. As shown in Figure 13, abalance in a horizontal beam 51 aflords suspension for a limb in aThomas splint, and a vertical balance beam 52 is employed to apply skintraction to the limb.

We claim:

1. An orthopaedic appliance for applying traction or suspensioncomprising a supporting element, means for mounting said element upon abed, a spring balance of the spiral rod type comprising a coiled tensionspring and a coiled torsion spring each anchored at one end, a spirallyformed rod coacting with the torsion spring and arranged to wind andunwind said spring and to extend and contract the tension spring whenone end of the balance is displaced relatively to the other end thereoftogether with means on said rod to vary the action of the torsion springas the tension spring is extended and thereby to afiord therebysubstantially constant traction, means for anchoring one end of saidspring balance to the supporting element, and flexible means attached tothe extensible end of the spring balance and adapted for connection to apart of the body of a patient on the bed.

2. An appliance according to claim 1 comprising pulley means adjustablymounted on the supporting element and arranged so that the flexiblemeans can be trained over said pulley element.

3. An appliance according to claim 1, in which the supporting element isof tubular form and the spring balance is enclosed therein.

4. An appliance according to claim 1, in which the supporting element isof tubular form having a longitudinal slot therein, and pulley meansadjustably mounted on the said element, the flexible means being trainedover the pulley means and extending through said slot.

5. An appliance according to claim 1, comprising guide means on theextensible end of the spring balance coating with the supporting elementto prevent twisting of said extensible balance end under torsion.

6. An appliance according to claim 1, in which the supporting element isof tubular form and the spring balance is enclosed therein, andcomprising a guide block on the extensible end of the spring balance,said guide block being slidable in the tubular element and coatingtherewith to prevent twisting of said extensible balance end undertorsion. l

7. An appliance according to claim 1, in which the assaoso means formounting the supporting element on the bed comprise adjustable clamps.

8. An appliance according to claim 1, in which two spring balances areanchored at opposite ends of a single supporting element and pulleymeans for each balance mounted on the said element to receive the twoflexible means for the balances.

9. An appliance according to claim 1, in which the tension spring andthe torsion spring are arranged one within the other and attached at oneend to a common anchorage, and further comprising a guide structureconstituting an extensible end of the balance to which the other end ofthe tension spring and also an end of the spirally formed rod areattached, and a nut member slidable on the spirally formed rod andattached to the other end of the torsion spring.

10. An appliance according to claim 1, in which the means for mountingthe supporting element on the bed comprises a clamp including an openended box structure slidable upon said element and a clamping screwthreaded in said box structure.

11. An appliance according to claim 1, in which the means for mountingthe supporting element on the bed comprises a clamp including a pair ofopen ended box structures arranged at right angles and each adapted toreceive a supporting element, and a clamping screw threaded into each ofsaid box structures.

12. An appliance according to claim 1, in which the means for mountingthe supporting element on the bed comprises a clamp including a pair ofbox structures arranged at right angles and each adapted to receive asupporting element, one of said box structures being open at both endsand the other being closed at one end only to fit over the end of asupporting element, and a clamping screw threaded into each of said boxstructures.

13. An appliance according to claim 1, in which the means for mountingthe supporting element comprises a clamp having a box structure slidableuponthe supporting element, and having a hook shaped extension forengaging over a bed rail.

14. An appliance according to claim. 1, in which the means for anchoringthe spring balance comprises a cap adapted to engage over an end of thesupporting element and catch means for holding said cap in position.

15. An appliance according to claim 1, in which the means for anchoringthe spring balance comprises a cap adapted to engage over an end of thesupporting element, catch means for holding said cap in position, andmeans on the cap for adjustably varying the torsion of the balance.

References Cited in the file of this patent UNITED STATES PATENTS

